Objective To investigate the protective effects and mechanism of shenmai injection(SMI) on cardiomyocytes injured by hydrogen peroxide(H 2O 2) or angiotension Ⅱ(AngⅡ). Methods According to the different concentrations of H 2O 2, AngⅡ,SMI,Vitamin C(VitC) added into the cardiomyocytes culture media(CCM), the cultures were divided into 15 groups. Lactate dehydrogenase(LDH ),malondialdehyde(MDA),superoxide dismutase (SOD) of CCM and cardiomyocytes viability(CMV), Na +-K +-ATPase,Ca 2+-ATPase?cardiomyocytes apoptosis rate(CMAR) ,nitrogen oxide(NO), nitrogen oxide synthesis enzyme(NOS),eNOS expression of cardiomyocytes were detected respectively .Results H 2O 2 or AngⅡ could decrease CMV, SOD, Na +-K +-ATPase,Ca 2+-ATPase,NOS,NO,eNOS expression and increase CMAR,LDH and MDA.SMI could lessen the changes of the items mentioned above ,which were caused by H 2O 2 or AngⅡ.The effects of SMI 10 ml/L were stronger than those of SMI 5 ml/L or VitC 50 mg/L.Conclusion SMI has a significant protective effect on cardiomyocyte injured by H 2O 2 or AngⅡ.

Objective To discuss the effectiveness of the second surgical procedure of adjacent segment degeneration after the first spinal fusion.Method 35 patients who had been performed spinal fusion in our hospital or had symptoms recurred or aggravated after 12 ～ 114 (42 ±35) months of the prior surgery were enrolled in this study.A second surgery was performed and intraoperative the intradiscal pressure of adjacent segments of degeneration and normal segments was measured.The VAS score systems were compared among prior surgery,3 months later and 2 years after the second surgery.Result The intradiscal pressure of adjacent segments after the cervical vertebra and lumbar vertebra fusion were [ (15 ± 4.6)cmH2O,(23 ±5.2)cmH2O],much higher than normal segments [ (3 ±2.3)cmH2O,(8 ±4.1)cmH2O](P ＜0.01).The VAS score systems of 3 months later and 2 years after the second surgery were [ (2.9 ±0.7),(2.0 ± 0.6) ],which were dramatically lower than the prior (7.8 ± 1.2) (P ＜ 0.01).In 12 ～ 46(31 ± 12) months of follow-up after the second procedure,X-ray and MRI showed that fusion segments reached nearly bone fusion,well decompressed and without nerve compression or other complications.Conclusion If recurrence of symptoms after spinal fusion were caused by adjacent segment degeneration,reoperation would guarantee good clinical outcome.

BACKGROUND:Currently, the cement delivery device used in vertebral augmentation vertebral augmentation (vertebroplasty and kyphoplasty) has flat tips that cannot be bent. During surgery, we always choose injection cement by symmetric way to keep the balance of power on the biomechanics of the vertebral body, while the traditional cement delivery tube can only be used in ipsilateral vertebral body.
OBJECTIVE:To evaluate the feasibility of curved vertebroplasty device for the treatment of thoracolumbar osteoporotic vertebral compression fractures.
METHODS: Sixty patients (72 vertebral bodies) with osteoporotic vertebral compression fractures were enroled, including 8 cases of double-level vertebral fractures and 2 cases of three-level vertebral fractures. Al operations applied curved delivery device in percutaneous vertebroplasty. We recorded operation time, intraoperative blood loss, and X-ray imaging data through prospective self control study. Treatment effect was evaluated with modified Oswestry disability index, Visual Analogue Scale scores and the World Health Organization Quality of Life assessment. The patients were folowed up for 6 months to 2 years.
RESULTS AND CONCLUSION: (1) Surgery was performed successfuly on al 60 patients. The average operation time was 27 minutes (20-45 minutes) for 50 cases by unilateral transpedicular approach. (2) The mean amount of bone cement in every single vertebral of al 72 vertebrae was averagely 6.4 mL (4.2-9.5 mL). Bone cement distribution had not been found to be biased one-sided without severe leakage. (3) Visual Analogue Scale score and Oswestry disability index were significantly improved at 1 day after treatment (P < 0.05). During the final folow-up, no significant difference was detected as compared with 1 day postoperatively (P > 0.05). (4) The ratio of good quality of life in 1 month than postoperatively (87%) and in the last folow-up (92%) was significantly greater compared with the preoperative ratio (27%) (P < 0.05). (5) These findings confirmed that curved vertebroplasty device in unilateral pedicle puncture could ensure bilateral symmetric distribution of bone cement. Al patients are satisfied with treatment. It is proved to be a feasible simple and safe method.

【Objective】 Heart Model(HM) is a new method of 3D automatic left ventricular quantitative technique. This experiment is designed to test the feasibility and reproducibility of HM in evaluating left ventricular volume and ejection fraction of patients with pacemaker. 【Methods】 Echocardiography was performed in 50 patients with pacemaker. All of the two-dimensional and three-dimensional images were collected. Biplane Simpson method, HM method and traditional 3D-manual method were used to measure left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVESV) and left ventricular ejection fraction(LVEF), respectively. The measurement results and post-processing time of the three methods were compared. At the same time, the repeatability of HM method within and between groups was evaluated. 【Results】 The differences among Simpson, HM and 3D-manual in the measures of LVEDV and LVEF were statistically significant(P<0.05). LVEDV and LVESV measured by HM were larger than those measured by 3D-manual(P<0.05), while LVEF had no statistical significance(P>0.05). HM and 3D-manual measurements had a very high correlation and consistency. Compared with Simpson and 3D-manual, HM method had the least post-processing time, and the repeatability was good within and between groups. 【Conclusion】 HM method for automatic evaluation of left ventricular volume and ejection fraction is rapid, feasible and highly reproducible.

Administration, Oral ; Anticoagulants/adverse effects* ; Atrial Fibrillation/drug therapy* ; Humans ; Stroke ; Vascular Calcification/drug therapy* ; Warfarin

【Objective】 To explore the differences of clinical medicine ，magnetic resonance imaging（MRI）and pathology in multifocal and multicentric breast cancer（MMBC）and unifocal breast cancer（UBC）. 【Methods】 In this retrospective analysis，55 MMBC and 68 UBC patients with pathology confirmed from April 2016 to February 2018 were enrolled，and the characteristics and difference of routine pathological types，molecular subtypes and MR enhancement types were compared. The relationships between MMBC ，UBC and the methods of clinical treatment were studied by correspondence analysis（CA）.【Results】Significant difference was observed between routine pathological types of MMBC and UBC（P < 0.001）. The high grade invasive ductal carcinoma was more frequent in maximal lesions of MMBC than in UBC lesions，whereas there was no statistical correlation between molecular subtypes，molecular subtypes and MR enhancement types（P = 0.265，P = 0.152）. However，there was statistical difference in masses enhancement（P = 0.013）. CA showed that the molecular subtypes of MMBC and UBC were the key factors for clinical treatment. In addition ，HER- 2（+）and Luminal B type breast cancer showed high correlation with treatment method，while triple-negative showed low correlation with treatment method.【Conclusions】The pathology types of the maximal lesions of MMBC were less aggressive than UBC lesions. There was significant correlation between clinical treatment and molecular subtypes of MMBC and UBC. Therefore，individualized treatments are recommended on the basis of biological characteristics in both MMBC and UBC.

OBJECTIVETo explore a better operative approach to resect complicated pelvic retroperitoneal tumors.

METHODSA total of 28 patients with complicated pelvic retroperitoneal tumors who received surgical resection in our hospital from 2006 to 2010 were included in this study. The surgical operation was assisted with an arc-shaped transperineal incision in front of the apex of coccyx. The operation time, intraoperative blood loss, death toll and length of hospital stay of the patients were retrospectively analyzed.

RESULTSThe median operation time was 122.5 minutes. The median blood loss was 420 ml, and the median length of hospital stay of the patients was 17.5 days. There was no postoperative death in this group of patients.

CONCLUSIONWith the assistance of this arc-shaped transperineal incision in front of the apex of coccyx, the resection of pelvic retroperitoneal tumors can be effectively improved and the surgery risk is reduced.

Adult ; Aged ; Blood Loss, Surgical ; Coccyx ; surgery ; Epidermal Cyst ; pathology ; surgery ; Female ; Gastrointestinal Stromal Tumors ; pathology ; surgery ; Humans ; Length of Stay ; Male ; Middle Aged ; Neurilemmoma ; pathology ; surgery ; Pelvic Neoplasms ; pathology ; surgery ; Retroperitoneal Space ; Retrospective Studies ; Teratoma ; pathology ; surgery

Objective To analyze retrospectively the clinico-pathological features that influencing the occurrence of anastomotie leakage after low anterior resection of rectal cancer, as well as its management and outcome of patients. Methods The data of 513 patients underwent anterior resection for low rectal cancer from june 1999 to June 2007 were reviewed. Results The incidence of anastomotic leakage was 4.5 %(23/ 513). 20 patients underwent conservative therapy,while 3 patients underwent reoperation, all patients were cured without ileostomy or colostomy.Conclusion The occurrence rate of anastomotie leakage is closely re- lated to the type of operation,the Dukes staging,Diabetes Mellitus and Diarrhea. Local irrigation via the drainage tube is the main strategic point to manage the leakage.

OBJECTIVETo investigate the feasibility of the endoscope-assisted styloidectomy.

METHODSSixty patients with Eagle's syndrome undergoing the endoscope-assisted styloidectomy via postauricular incision, including 7 unilateral and 53 bilateral, between June 2010 and March 2013 were reviewed.

RESULTSThe styloid processes in all patients were resected successfully via this approach, with the incision length range of 2.0 to 2.5 cm. The mean operative time was (21.3 ± 4.8) min(X(-) ± s), for unilateral surgery and (48.5 ± 11.4) min for bilateral surgery. Fifty-four patients symptom showed complete remission of symptom, 3 cases with decrease in symptom and other 3 cases with no significant relief of symptom after surgery. None case recurred for follow-up of 3 to 70 months. There were 3 sides with ear numbness after surgery for 3 months, and one case had transient facial paralysis and recovered after 3 months.

CONCLUSIONSThe endoscope-assisted styloidectomy via postauricular incision is effective and feasible.

Adult ; Aged ; Endoscopes ; Female ; Humans ; Male ; Middle Aged ; Ossification, Heterotopic ; surgery ; Osteotomy ; methods ; Temporal Bone ; surgery

Objective: This study aimed to evaluate the efficacy and safety of programmed death-1 (PD-1) inhibitor combined tyrosine kinase inhibitor (TKI) therapy versus TKI monotherapy as the second-line regimen for patients with metastatic non-clear cell renal carcinoma (nccRCC) who failed first-line TKI therapy. Methods: The clinicopathological data of 67 patients with metastatic nccRCC who failed first-line TKI therapy between October 2011 and September 2020 were retrospectively analyzed, including 22 patients who received TKI monotherapy and 45 patients who received TKI plus PD-1 inhibitor as the second-line therapy. The efficacy was assessed according to Response Evaluation Criteria in Solid Tumors version 1.0/1.1 (RECIST 1.0/1.1), the Kaplan-Meier method was used to plot the survival curves, and the Log rank test was used to analyze the differences in the survival between the two groups. Treatment-related adverse events (AEs) after treatment were observed in both groups. Results: The overall objective response rate (ORR) and disease control rate (DCR) were 37.3% (25/67) and 56.7% (38/67), respectively. The overall second-line progression-free survival (PFS) was 7.7 months and Overall Survival (OS) was 25.2 months. The ORR and DCR of patients in the combination therapy group were 48.9% (22/45) and 71.1% (32/45), respectively, which were significantly improved compared with the TKI monotherapy group [13.6% (3/22) and 27.3% (6/22), respectively] (P=0.007 and P=0.001, respectively). The median PFS of 9.2 months for second-line treatment was longer in patients in the combination therapy group than in the TKI monotherapy group (5.2 months, P=0.001), but the median OS was not statistically different between the two groups (28.2 months vs 20.8 months, P=0.068). Common treatment-related AEs included hypertension, diarrhea, fatigue, stomatitis, hand-foot syndrome, and hypothyroidism. The incidence of hypothyroidism was higher in the combination therapy group [40.0% (18/45)] than in the TKI monotherapy group [22.7% (5/22), P=0.044]; the incidence of other treatment-related AEs between the two groups were not statistically significant (all P>0.05). Conclusion: Immune-targeted combination therapy was more effective than TKI monotherapy alone and was well tolerated in the treatment of metastatic nccRCC patients who failed first-line TKIs.
Humans ; Carcinoma, Renal Cell/drug therapy* ; Immunotherapy/adverse effects* ; Kidney Neoplasms/drug therapy* ; Retrospective Studies